Quality-of-life outcomes of patients with breast cancer in an integrative cancer treatment setting.

Abstract

1107 Background: There is evidence in the literature to suggest that patients undergoing cancer therapy experience an initial deterioration in their quality of life (QoL). We longitudinally investigated the impact of an integrative care model characterized by conventional cancer treatment in combination with a comprehensive, complementary program on QoL outcomes of patients with breast cancer. Methods: We examined a random sample of 689 breast cancer patients treated at two single-system cancer centers from January 2001 to December 2008 who were available for a minimum follow-up of 3 months. QoL was evaluated using the validated survey instrument European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-C30) at baseline and after 3 months of treatment. The QLQ-C30 provides a global score as well as five functional and nine symptom scores. Higher scores in the global and functional scales and lower scores in the symptom scales indicate better QoL. The mean QoL scores were compared using paired sample t-test. Results: QoL scores for all patients together were well maintained from baseline to 3 months for both global scores (63.6 vs. 61.7, p=0.11) and across scales, excluding emotional functioning (66.6 vs. 71.3, p<0.001) and insomnia (36.7 vs. 32, p=0.003), both of which actually improved at 3 months. There were 257 analytic and 432 non-analytic patients whose mean global QoL scores were 67 and 61.5 at baseline (p=0.005) and 65 and 59.7 at 3 months (p=0.006). There was no significant difference in mean global scores at baseline as compared with 3 months for either analytic or non-analytic patients. Patient's stage of disease at diagnosis was I, 133; II, 282; III, 145; and IV, 85. Mean global QoL scores for locoregional (stages I-III) and metastatic (stage IV) disease patients were 63.4 and 65.2 at baseline (p=0.53) and 61.9 and 59.8 at 3 months (p=0.45); there was no significant difference in mean global scores at baseline as compared with 3 months for either loco-regional or metastatic disease patients. Conclusions: This study suggests that the QoL outcomes of patients with breast cancer are maintained and may even be improved while undergoing therapy in an integrative cancer treatment setting. No significant financial relationships to disclose.